A DOUBLE-BLINDED COMPARISON OF METOCLOPRAMIDE AND DROPERIDOL FOR PREVENTION OF EMESIS FOLLOWING STRABISMUS SURGERY
A DOUBLE-BLINDED COMPARISON OF METOCLOPRAMIDE AND DROPERIDOL FOR PREVENTION OF EMESIS FOLLOWING STRABISMUS SURGERY
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DOI：
10.1097/00000542-199203000-00006
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发表时间：
1992-03-01
期刊：
影响因子：
8.8
通讯作者：
RODARTE, A
中科院分区：
文献类型：
--
作者：
LIN, DM;FURST, SR;RODARTE, A
斜视手术后的儿童在术后期间呕吐是常见的。110例儿童患者，年龄8个月至14岁，入院接受门诊斜视手术，被纳入一项随机、双盲研究，比较氟哌利多和甲氧氯普胺与安慰剂预防术后呕吐。每名儿童前瞻性随机分配到四个治疗组之一：甲氧氯普胺0.15 mg/kg，甲氧氯普胺0.25 mg/kg，氟哌利多0.075 mg/kg，或生理盐水对照。吸入麻醉诱导后立即静脉给药。未使用神经肌肉阻滞剂。在患者仍处于深度麻醉状态时进行气管拔管。对所有儿童术后疼痛给予标准剂量的对乙酰氨基酚和哌替啶。氟哌利多组和胃复安0.25mg/kg组的呕吐发生率分别为33%和29%，均低于对照组的88%（P < 0.01）。接受甲氧氯普胺0.15 mg/kg的患者呕吐发生率为68%（P无显著性）。与对照组相比，各治疗组的平均呕吐次数减少（P < 0.05）。接受氟哌利多和甲氧氯普胺0.25 mg/kg的患者术后住院时间（甲氧氯普胺201 min;氟哌利多213 min）也比对照组（258 min，P < 0.05）缩短。没有孩子表现出锥体外系症状，过度嗜睡，或激动。我们得出结论，在手术开始前给予0.25 mg/kg剂量的甲氧氯普胺，在预防术后呕吐方面至少与氟哌利多一样有效，并且与对照组相比，可以缩短患者出院时间。
Vomiting in the postoperative period is common in children after strabismus surgery. One hundred ten pediatric patients, ages 8 months to 14 yr, admitted for outpatient strabismus surgery were enrolled in a randomized, double-blinded study to compare droperidol and metoclopramide to placebo for the prevention of postoperative emesis. Each child was prospectively assigned at random to one of four treatment groups: metoclopramide 0.15 mg/kg, metoclopramide 0.25 mg/kg, droperidol 0.075 mg/kg, or saline control. Drugs were administered intravenously immediately after induction of inhalation anesthesia. No neuromuscular blocking agents were used. Tracheal extubation was performed while patients were still deeply anesthetized. Acetaminophen and meperidine were given in standard doses for postoperative pain to all children. The incidence of vomiting was less in both the droperidol (33%) and metoclopramide 0.25 mg/kg (29%) groups when compared to controls (88%) (P < 0.01). Patients receiving metoclopramide 0.15 mg/kg had a 68% incidence of vomiting (P not significant). The mean frequency of emesis was reduced in all treatment groups compared with control (P < 0.05). Patients receiving droperidol and metoclopramide 0.25 mg/kg also had decreased postoperative stays (metoclopramide 201 min; droperidol 213 min) versus control (258 min, P < 0.05). No child exhibited extrapyramidal symptoms, excessive drowsiness, or agitation. We conclude that metoclopramide in a dose of 0.25 mg/kg, administered prior to the start of surgery, is at least as effective as droperidol in preventing postoperative emesis and can reduce the time to patient discharge compared to control.